title: Somatic hypermutation of IGVH genes and aberrant somatic hypermutation in follicular lymphoma without BCL-2 gene rearrangement and expression.
abstract: BACKGROUND
  Follicular lymphoma is characterized by the t(14;18) translocation resulting in constitutive expression of BCL-2 protein; however approximately 10-15% of follicular lymphomas do not express BCL-2 protein, and a small fraction of these cases does not exhibit translocation of the BCL-2 gene either. It is highly debated whether cases of follicular lymphoma without BCL-2 gene rearrangement and expression represent a separate lymphoma entity with distinct biological characteristics, different from the BCL-2-positive cases.
  
  
  METHODS
  To further characterize follicular lymphomas without BCL-2 gene rearrangement and expression, we analyzed and compared the mutational status of IGVH genes as well as other genes (C-MYC, PAX-5 and RHOH) frequently involved in the specific type of genomic instability called aberrant somatic hypermutation in 11 cases of BCL-2-negative and 7 cases of BCL-2-positive follicular lymphomas. We also determined the levels of expression of activation-induced cytidine deaminase in these cases.
  
  
  RESULTS
  The analyzed cases were grade 2 and grade 3A follicular lymphomas. Our findings demonstrate that follicular lymphomas without BCL-2 gene rearrangement and expression are associated with ongoing somatic hypermutation of the IGVH genes, low activity of aberrant somatic hypermutation and elevated activation-induced cytidine deaminase expression. These results were in concordance with the results found in the cases of BCL-2-positive follicular lymphoma.
  
  
  CONCLUSIONS
  Although, BCL-2 protein overexpression is considered to be a critical pathogenic event in the development of follicular lymphoma, our findings suggest that follicular lymphomas with the same morphology, immunophenotype, mutational pattern and activation-induced cytidine deaminase expression may develop without the involvement of BCL-2 gene. The present data support the hypothesis that BCL-2-positive and BCL-2-negative follicular lymphomas (grades 1-3A) represent a homogenous group with different initial but several common additional molecular pathways.
authors.affiliation: First Department of Pathology and Experimental Cancer Research, Faculty of Medicine, Semmelweis University, Budapest, Hungary.
authors.forename: Eva
authors.initials: E
authors.lastname: Gagyi
authors.forename: Zsófia
authors.initials: Z
authors.lastname: Balogh
authors.forename: Csaba
authors.initials: C
authors.lastname: Bödör
authors.forename: Botond
authors.initials: B
authors.lastname: Timár
authors.forename: Lilla
authors.initials: L
authors.lastname: Reiniger
authors.forename: Linda
authors.initials: L
authors.lastname: Deák
authors.forename: Judit
authors.initials: J
authors.lastname: Csomor
authors.forename: Balázs
authors.initials: B
authors.lastname: Csernus
authors.forename: Agota
authors.initials: A
authors.lastname: Szepesi
authors.forename: András
authors.initials: A
authors.lastname: Matolcsy
mesh_terms: D000328:Adult; D000368:Aged; D019938:Cyclin D1 / Q000032:analysis / Q000235:genetics; D005260:Female; D005803:Genes, Immunoglobulin; D006801:Humans; D007143:Immunoglobulin Heavy Chains / Q000235:genetics*; D007135:Immunoglobulin Variable Region / Q000235:genetics*; D008224:Lymphoma, Follicular / Q000235:genetics*; D008297:Male; D008875:Middle Aged; D027041:Somatic Hypermutation, Immunoglobulin
chemical_list: D007143:Immunoglobulin Heavy Chains; D007135:Immunoglobulin Variable Region; D019938:Cyclin D1